MEDICARE: ELLEN BENTZ

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	374J00000X	Doula

General Provider Information

NPI Number	:	1992696512
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELLEN BENTZ

Provider Business Mailing Address
First Line	:	2377 N 73RD ST
Second Line	:
City	:	WAUWATOSA
State	:	WI
Zip	:	53213-1209
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2377 N 73RD ST
Second Line	:
City	:	WAUWATOSA
State	:	WI
Zip	:	53213-1209
Country	:	US
Telephone Number	:	835-239-8855
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/11/2025
Last Update Date	:	07/11/2025

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Directions to “ ELLEN BENTZ ” Practice Location

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